كيفية إعطائه الجلوكاجون
الجلوكاجون هو دواء يستخدم لعلاج انخفاض مستوى السكر في الدم. في هذا الدليل، سوف تتعلمين كيفية إعطاء طفلك الجلوكاجون.
Yawkey Center for Outpatient Care
55 Fruit Street, Suite 6C
Boston, MA 02114
Hours: Monday–Friday, 8:30 a.m.–5:00 p.m.
To schedule an appointment with a Mass General Children pediatric specialist, please call 888-644-3248 or complete our online appointment form to request an appointment.
Physicians may call 888-644-3211 or use the online referral form and the Access & New Appointment Center will call your patient within one business day.
Massachusetts General Hospital | Wentworth-Douglass Hospital (wdhospital.org)
Every patient of the Pediatric Endocrine Unit has a personal endocrinologist. We work collaboratively with primary care physicians, other specialty caregivers, and—most importantly—patients and their families to deliver the highest quality of care.
Our physicians specialize in the diagnosis and treatment of all endocrine-related conditions of infants, children and adolescents, including:
Lynne Levitsky, MD, Chief Emeritus
Jacqueline Maya, MD
Kemal Topaloglu, MD
Janaki Vakharia, MD
Imen Becetti, MD
Kathryn E. Nagel, MD
Mariann D’Amore Gibson RN, MSN
Evelyn Lozano, RN
Maureen O'Meara, NP
Dr. Misra’s research to date has focused on clarifying neuroendocrine and bone alterations in conditions that span the weight spectrum from anorexia nervosa to the female athlete with amenorrhea to obesity. She has also worked on bone outcomes in children with autism spectrum disorder and type 1 diabetes. Studies from the Pediatric Endocrine-Neuroendocrine-Sports Endocrine Laboratory (Misra Lab) have contributed greatly to the understanding of low bone density and impaired bone accrual in teenagers with anorexia nervosa and athletes with amenorrhea, and the pathophysiology underlying these changes. Dr. Misra has worked on therapeutic strategies to optimize bone mass in adolescents and young adult women with these conditions, and demonstrated the efficacy of physiologic estradiol replacement administered as the transdermal patch (with cyclic progesterone) (but not the oral contraceptive pill) in increasing bone accrual. She has also demonstrated the efficacy of IGF-1 replacement over the short-term in increasing bone formation in young women with anorexia nervosa; however, addition of recombinant IGF-1 to young women receiving physiologic estradiol replacement with cyclic progesterone does not further improve bone outcomes. Through another grant, the group is exploring whether alterations in food motivation pathways in specific brain regions and alterations in appetite regulating peptides underlie restricting, bingeing, and purging behaviors in girls with low-weight eating disorders, and whether these alterations are associated with long-term outcomes. Dr. Misra (with Dr. Eddy) is also studying the impact of estrogen replacement on cognitive flexibility and reward responsiveness in young hypoestrogenic women with restrictive eating patterns.
At the other end of the weight spectrum, the Misra Lab has examined neuroendocrine determinants of site specific fat depots in adolescents with obesity, an important predictor of the metabolic syndrome, and the implication of specific macronutrients on hunger and food intake. The group has reported on the deleterious effect of sleeve gastrectomy on bone outcomes in adolescents and young adults with obesity, and is also examining the impact of gastric bypass on these outcomes. With her collaborators (Drs. Bredella and Lawson), Dr. Misra is examining the efficacy of intranasal oxytocin as a weight loss therapy in adolescents with obesity.
Dr. Misra’s work with investigators at the Lurie Center for Autism has demonstrated lower bone density in peripubertal and pubertal boys with autism spectrum disorder (ASD) compared with typically developing controls, and a higher risk of certain kinds of fracture in children and adults with ASD. She is collaborating with Drs. Neumeyer and Lawson at the Lurie Center and the Neuroendocrine Unit of MGH on a study examining the osteoanabolic role of intranasal oxytocin in children with ASD. She is also working with Drs. Mitchell and Bouxsein on a study examining bone accrual in children and young adults with type 1 diabetes.
Dr. Misra is currently the principal investigator or co-investigator of several NIH and DoD studies.
Website: MGH Adolescent Neuroendocrine Unit
About Madhusmita Misra, MD, MPH
Dr. Misra completed her fellowship in Pediatric Endocrinology at Mass General Hospital (MGH) and Masters in Public Health at the Harvard School of Public Health. She is Chief of the Division of Pediatric Endocrinology at MGfC, Associate Director of the Harvard Catalyst Translational and Clinical Research Center (MGH) and Director of the Pediatric Endocrine-Sports Endocrine-Neuroendocrine Lab (MGH). Dr. Misra has chaired the Drugs and Therapeutics Committee, the Fellow Spring Retreat, and the Research Affairs Council of the Pediatric Endocrine Society (PES). She is an ex-Director and Past President of the PES, and on the Subboard of Endocrinology for the ABP. Dr. Misra has received the William Silen Lifetime Achievement in Mentoring Award (HMS), the Outstanding Mentor Award (PES), the John Haddad Young Investigator Award (AIMM-ASBMR), the Janet W. McArthur Award (Women in Endocrinology), the Claflin Distinguished Scholar Award (MGH) and the Rita M. Kelley, MD, Fellowship (MGH).
Dr. Misra specializes in neuroendocrine and bone disorders. She is internationally known for her work on neuroendocrine, metabolic and bone complications in anorexia nervosa, exercise induced amenorrhea, obesity, and autism spectrum disorders, and her work has led to major strides in the clinical management of these conditions. Dr. Misra has a special clinical interest in pituitary disorders, and her panel includes children with some of the most complex pituitary tumors. She is associated with the multidisciplinary Neuroendocrine Clinical Center at MGH, and is often asked to provide second opinions on complex pituitary cases. In addition, Dr. Misra sees children with growth and puberty disorders, reproductive, adrenal and thyroid disorders, and children with diabetes.
Dr. Singhal’s research interests include investigations of causes and treatments of obesity and its complications. Her goal is to optimize the care of children and adolescents with this chronic multifactorial and complex disorder. She leads the pediatric obesity program at the MGH Weight center and the obesity pharmacotherapy program in the division of pediatric endocrinology. Her efforts involve streamlining the care of patients by optimizing the referral of these patients in a timely manner, provide education to trainees and colleagues for stage appropriate management of pediatric obesity and envisions streamlining the care of patients with obesity so that they can have a medical home to solve their weight struggles at Mass General. She was funded by NIH to explore the changes in insulin secretion after weight loss surgery in adolescents and young adults and is currently collaborating on other projects like evaluating the role of oxytocin hormone in adolescents with obesity.
Dr. Jindal’s research interests include clinical investigations of the association of sleep and obesity in children. Her research has demonstrated that sleep parameters such as poor sleep quantity and quality are associated with decreased physical activity and energy expenditure in children. In addition, she is also interested in investigating cardiometabolic outcomes in children with obesity and youth onset diabetes. She is currently examining knowledge, attitudes, practices and beliefs of physicians for management of obesity with weight loss surgery in children and adolescents.
About Ishita Jindal, MD
Ishita Jindal, MD, is a pediatric endocrinologist with particular interests in type 1 diabetes, type 2 diabetes and obesity. She completed her pediatric residency at John H Stroger Hospital of Cook County in 2017, and a fellowship in pediatric endocrinology at Texas Children’s Hospital, Baylor College of Medicine in 2020. She is the Associate Director of Pediatric Diabetes Center at the Massachusetts General Hospital for Children (MGHfC).
The activities of the hypothalamo-pituitary–gonadal (HPG) axis from late embryo to young adulthood provide essential inputs to human development. Dr. Kemal Topaloglu’s goal has been to gain full insight into the central regulation of the HPG axis throughout human life stages and particularly to determine what drives pubertal onset. Over the past 15 years, with the collaboration of his dear colleagues, Dr. Topaloglu has identified and seminally reported several genes associated with pubertal failure. The most notable of these are TAC3 (encoding neurokinin B), TACR3 (encoding the neurokinin B receptor), and KISS1 (encoding kisspeptin), which were instrumental in defining our current understanding of the GnRH pulse generator as the KNDy (Kisspeptin/NKB/Dynorphin) neurons in the hypothalamic arcuate nucleus. The neuropeptides, kisspeptin, and neurokinin B (encoded by TAC3 and KISS1, respectively), along with dynorphin, constitute the KNDy cells, in which each peptide had a distinct role: NKB as the start signal, kisspeptin as the output driving GnRH and dynorphin as the stop signal terminating each pulse. The reactivation of the KNDy cells at the beginning of the second decade of human life underlies the start of puberty, a major life event denoting the end of the childhood (juvenile) life stage and the beginning of another, adolescence (and subsequently young adulthood). This new life stage is characterized by developing secondary sex characteristics, psychosocial identity, and maturing reproductive capacity. Although we now roughly know the identity and inner mechanisms of the GnRH pulse generator, the stimulus that reactivates it after a prolonged quiescence during childhood to start puberty remains an enigma. Identification of such stimulus represents his current research challenge. Insufficiency of the HPG often results in delayed/absent puberty, which is a major cause of distress among affected adolescents. As a clinician, he is particularly interested in caring for children and adolescents with puberty problems.
About A. Kemal Topaloglu, MD
After graduating from the Cukurova University, Faculty of Medicine in Adana and subsequently training in Pediatrics at the Istanbul Zeynep Kamil Children’s Hospital in Turkey, Dr. Topaloglu came to the USA to do his training in Pediatric Endocrinology at the Loyola University of Chicago, followed by a postdoctoral fellowship in Molecular Genetics at the Mount Sinai School Medical Center. In 1999, he returned to Turkey and worked as a professor at his alma mater until he came back to the USA in 2016 to work at the University of Mississippi Medical Center. He joined the Division of Pediatric Endocrinology at MGH in 2022.
In his current post, he has enjoyed being a clinician/scientist academician throughout his career. Dr. Topaloglu has authored over 100 peer-reviewed articles and textbook chapters and presented at major international conferences. His research has focused on how the hypothalamo-pituitary–gonadal axis is regulated, specifically, what starts puberty, which remains an enigma to date. Most notably, in association with his colleagues, he has discovered the essential role of neurokinin B and its receptor in human puberty. These findings helped characterize the GnRH pulse generator as the Kisspeptin (KNDy) neurons of the hypothalamus in the brain. His eventual aim is to gain complete insight into the stimuli initiating the pubertal process and the underlying mechanisms leading to delayed and absent puberty in adolescents.
I am a clinician scientist who cares deeply about my patients and their quality of life and love understanding the physiology of hormones and their interactions with multiple organ systems.
Dr. Sethuram is dedicated to clinical research. Her work has focused on several topics, including a clinical trial of growth hormone and its effects on repetitive behavior outcomes in children with Phelan Mcdermid Syndrome, a rare form of autism. She has also studied the effects of endocrine disruptors, phthalates, on play behavior in children, as well as the association of prenatal maternal sex hormones and play behavior in children at four years of age.
About Swathi Sethuram, MD
Dr. Sethuram completed medical school at M.S. Ramaiah Medical College, India. She pursued her General Pediatric residency at Lincoln Medical and Mental Health Center in New York City, where she served as chief resident. Dr. Sethuram went on to complete a fellowship at the Icahn School of Medicine at Mount Sinai, further honing her skills and expertise in the field of pediatric endocrinology. Prior to joining MassGeneral for Children, she worked as a pediatric endocrinologist at Saint Peter’s University Hospital in New Jersey.
While caring for children with a broad range of endocrine issues, her focus lies in adrenal disorders and differences in sexual development (DSD). Dr. Sethuram also cares for patients with thyroid disorders, cancer-related endocrine issues, growth disorders, menstrual disorders and diabetes mellitus. She is proud to be a member of the MGH leukodystrophy clinic, where she offers her expertise in treating children with rare genetic disorders affecting the brain and adrenal glands. Dr. Sethuram strives to provide compassionate care through a personalized approach for her patients and their families, and is committed to helping them achieve optimal health and well-being.
I am a board-certified pediatric endocrinologist with a strong interest in how health behavior like physical activity, nutrition, and sleep can be targeted to prevent endocrine complications of childhood obesity. I completed my clinical and research fellowship within the Divisions of Pediatric Endocrinology and General Academic Pediatrics at Massachusetts General Hospital, with concurrent participation in the Harvard Pediatric Health Services Research and Institute for Healthcare Improvement Fellowships as well as completion of an MPH at the Harvard School of Public Health. I am currently a junior faculty member within the Department of Pediatrics at MGH, continuing my work in both General Academic Pediatrics and Endocrinology. My prior research has focused on strategies for the implementation of physical activity promoting policies, primarily within school-based settings.
To date, I have focused on community-based physical activity policies and interventions in childcare and school settings, as well as developing early life obesity prevention initiatives. This work has provided experience in community-based physical activity programs, qualitative analyses, and the importance of engaging with community partners to develop sustainable interventions. My current work examines the development of a common endocrine condition (polycystic ovary syndrome, or PCOS) with significant morbidity among young females and examines how physical activity behaviors may impact PCOS development.
Dr. Vakharia’s interests are focused on improving health care delivery for young adults with chronic endocrine conditions as they transition to the adult health care setting and understanding the gaps in endocrine providers’ knowledge and resources for caring for complex young adult patients. She has designed a novel care model for young adults with diabetes that focuses on patients’ diabetes care, mental health, and overall well-being as they transition to the adult care setting. Dr. Vakharia has conducted a mixed methods pilot feasibility study on this model, and plans to continue with quality improvement, observational, and qualitative studies to better understand how to support and enhance comprehensive care for young adults with diabetes and other chronic endocrine conditions.
About Janaki Vakharia, MD
Janaki D Vakharia is a combined adult and pediatric endocrinologist at Massachusetts General Hospital and Massachusetts General Hospital for Children. She obtained her medical degree at the Jacob’s School of Medicine and Biomedical Sciences in Buffalo, NY and completed her Internal Medicine and Pediatrics residency program at Brown University’s Rhode Island Hospital/Hasbro Children’s Hospital in Providence, RI and her combined endocrinology fellowship at Massachusetts General Hospital. Her clinical and research interests are focused on improving health care delivery for young adults with chronic endocrine conditions as they transition to the adult health care setting and understanding the gaps in endocrine providers’ knowledge and resources for caring for complex young adult patients. Dr. Vakharia has experience with designing a novel care model for young adults with diabetes that focuses on patients’ diabetes care, mental health, and overall well-being as they transition to the adult care setting, and she is the Director of the Diabetes Collaborative Care Clinic for Young Adults at the MGH Diabetes Center.
Dr. Maya’s interests lie in understanding modifiable risk factors that contribute to the development of childhood obesity to work towards interventions that decrease the risk of developing diabetes and other long term cardiometabolic complications over the life course. Her research focuses on identifying children that are most at risk as early as possible to intervene using targeted preventative approaches, with a focus on obesity risk factors during the prenatal period.
Maureen O’Meara, NP
Maureen O’Meara, RN, CPNP-PC is a registered nurse and board-certified pediatric nurse practitioner working in the department of pediatric endocrinology at the Massachusetts General Hospital for Children. She grew up in the Boston area and attended the College of the Holy cross in Worcester, MA for her undergraduate education, majoring in Biology. After undergraduate school, she worked at Massachusetts General Hospital in the Wein research lab of the endocrine unit focusing on bone health and osteoporosis. While working in the lab, she realized her passion for patient-focused care. She then started a masters program at Boston College where she obtained a Masters of Science and became a certified pediatric nurse practitioner. She first worked in a primary care setting in the New Haven, CT area. After some time in this setting, she found that she wanted to focus on a specialty area of medicine and started working here in the pediatric endocrine department. Her areas of interest include diabetes mellitus and thyroid disorders.
Evelyn Fan Lozano, RN is a Registered Nurse at the Pediatric Endocrine Program and Diabetes Center
View the full collection of patient education resources from the Pediatric Endocrinology and Diabetes Center at MGfC.
Pediatric Endocrinology Fellowship
The Pediatric Endocrinology Fellowship Program at Mass General for Children spans three years of training and prepares our fellows for careers as leaders in academic medicine and also clinical practice.
Pediatric Endocrine-Neuroendocrine-Sports Endocrine Research
Research within the Pediatric Endocrine-Neuroendocrine-Sports Endocrine Lab aims to further medical knowledge about common endocrine issues in athletes and girls with low-weight eating disorders. In particular, we focus our efforts on establishing findings that lead to the adaptation and improvement of medical care for female athletes and young girls and women with eating disorders.
Pediatric Research in the Metabolism Unit
The Metabolism Unit, housed in the MGH Endocrine Division, investigates broad themes of adiposity, metabolism, inflammation, ectopic fat deposition, and cardiovascular disease. The Unit includes both adult and pediatric research, with a cross-disciplinary approach aimed at tackling underlying themes in obesity and metabolism.
Nonalcoholic fatty liver disease, or NAFLD, is a common occurrence in individuals living with obesity and/or Type 2 diabetes, and it can also occur in lean individuals. NAFLD encompasses a spectrum from “simple steatosis” – having fat deposition in the liver cells without other changes – to “nonalcoholic steatohepatitis (NASH),” in which fat deposition is accompanied by inflammation, cellular damage, and/or scarring. NASH can lead to substantial liver damage and dysfunction, such that research into strategies for addressing NASH and NAFLD is greatly needed. We have previously demonstrated that administration of a growth hormone releasing hormone analog reduces liver fat and decreases the rate of progression to fibrosis in individuals with HIV. Current efforts including investigating the efficacy of growth hormone to reduce liver fat in young adults and the efficacy of growth hormone releasing hormone to ameliorate liver disease in adults with obesity and NAFLD.
Previous work in the Metabolism Unit has included characterization of mitochondrial function in children living with obesity, as well as work performed in adults to demonstrate various contributors to obesity including mitochondrial dysfunction and systemic inflammation. Current pediatric work in the unit aims to determine the efficacy of following guidelines for obesity treatment in the pediatric primary care setting as well as characterizing possible effects of in utero exposure to HIV on later-life metabolic and immune function.
Seeking overweight girls and boys 13-25 years old
Our Mission: To understand the effect of weight loss surgery versus no surgery (usual care) on bone density and strength and body composition.
6 total visits over 26 months (and an optional visit), including:
If interested, call Amita Bose at 617-643-0266 or email ANEresearch@partners.org.
We are interested in the effect of type 1 diabetes on bone density. We are looking for children and young adults ages 6-20 years with type 1 diabetes who are otherwise healthy in order to learn how their bone density changes over time.
If interested, contact:
Pediatric Endocrine Unit
Massachusetts General Hospital
or visit our website.
We are interested in the effect of type 1 diabetes on bone density. We are looking for healthy children and young adults ages 6-20 years without diabetes in order to compare them to people with diabetes.
If interested, contact Kate Kilroe
Pediatric Endocrine Unit
Massachusetts General Hospital
or visit our website.
Requirements for participation
Low-Weight or Athletic young women 16-26 years of age not getting their periods
Payment for participation up to $500 and parking/ transportation expenses offered
Visit our website: www.ANEresearch.com
The Mass General for Children Pediatric Endocrine Unit’s values are seated in the respect we show each other, our patients and their families. Through kindness and dedication and with the highest integrity we strive to provide the most equitable, patient-centric, holistic, and state-of-the-art care for children, families, and our community.
The vision of the Division of Pediatric Endocrinology is to:
The mission of the Division of Pediatric Endocrinology is to:
Care teams across Mass General for Children are available to provide care via phone or online video visits. Call 888-644-3248 to learn more.
Articles and Q&As from providers across MGfC on how to take care of your children and yourself during the COVID-19 pandemic.
الجلوكاجون هو دواء يستخدم لعلاج انخفاض مستوى السكر في الدم. في هذا الدليل، سوف تتعلمين كيفية إعطاء طفلك الجلوكاجون.
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